New World Bank financing aims to strengthen Indonesia's tuberculosis response program

By World Bank

New World Bank financing aims to strengthen Indonesia's tuberculosis response program

On December 19, 2022, the World Bank’s Board of Executive Directors has approved a $300 million loan to the Indonesian government on December 19, 2022, to improve coverage, quality and efficiency of tuberculosis (TB) response in Indonesia.

Indonesia’s health system has seen increasing challenges to find and treat TB cases, especially since the beginning of the COVID-19 pandemic. Even before the pandemic, Indonesia was the third largest contributor to global TB cases. In 2021, the country contributed around 9 percent of the total 10.6 million new TB cases worldwide. It had a TB incidence of over 969,000 people and lost more than 150,000 people annually because of this communicable disease.

Besides the significant impact on health and human capital, the economic burden of TB is substantial. A study estimated that the overall annual cost of TB in Indonesia to be US$6.9 billion annually, including the loss of productivity because of illness and premature death.

“The World Bank financing will help strengthen Indonesia’s National Tuberculosis Program (NTP) that has been significantly challenged by the COVID-19 pandemic,” said Budi Gunadi Sadikin, Minister of Health of the Republic of Indonesia. “It will contribute to the Ministry’s health transformation agenda through strengthened primary healthcare response and achieve our goal to reduce 90 percent of new TB cases by 2030,” the Minister added.

The new financing is implemented in partnership with the Global Fund through an innovative results-based buydown mechanism in which the Global Fund makes available a sum of US$20 million to reduce the interest and principal repayment of the Government of Indonesia. The Global Fund is an international partnership funded primarily by governments to accelerate the end of AIDS, tuberculosis and malaria as epidemics.

The financing uses a results-based approach that will focus on three areas. The first area is strengthening Indonesia’s subnational TB response, such as case finding, treatment coverage, and timely response, and the performance in this area will be linked to a fiscal transfer.

The second is strengthening TB response among primary health providers, including private healthcare providers. The financing will help better connect private sector providers with the national program, and making it easier for them to notify, diagnose, and treat TB by improving their access to diagnostics and medicines provided by the NTP.

The third is enhancing digital systems for TB and well-informed policies through creating an ecosystem aimed at minimizing the reporting burden and improving data availability and reliability. This ecosystem will support better equity, access, and monitoring of the TB program among the public and private sectors’ healthcare.

“Indonesia’s commitment to eliminate TB has been demonstrated and the World Bank is proud to support this fight. Our financing will strengthen Indonesia’s TB response while paving the way for a stronger primary healthcare system, incorporating the lessons learned from this program,” said Satu Kahkonen, World Bank Country Director for Indonesia and Timor-Leste.

The new support from the World Bank is in line with its Country Partnership Framework 2021-2025, particularly in nurturing human capital by strengthening quality and equity in health services.